Abstracts

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E1569. Persistence of Fluoroscopic Techniques Into the 21st Century for the Evaluation of Acute and Chronic Conditions of the Male Urethra
Authors
  1. Nandan Keshav; University of New Mexico
  2. Jonathan Revels; University of New Mexico
  3. Mark Ehrhart; University of New Mexico
  4. William Thompson; University of New Mexico
  5. Margarita Revzin; Yale University
  6. Douglas Katz; NYU Winthrop Hospital
  7. Mariam Moshiri; University of Washington
Background
Male urethral pathologies span all ages and may be congenital or acquired. Radiologists have a pivotal role in diagnosing urethral abnormalities, and as such, an understanding of their classification and proper imaging technique is necessary. This presentation will discuss proper fluoroscopic technique with diagrammatic representation of optimized fluoroscopic evaluation of the urethra, familiarize the radiologist with the imaging presentation of normal urethral anatomy and anatomic variants, review both common and uncommon radiological findings of acute and chronic benign and malignant male urethral pathologies, as well as discuss mimics of urethral disease.

Educational Goals / Teaching Points
After reviewing this presentation, learners will have an improved understanding of radiologic evaluation of the male urethra, including: -Proper patient positioning, technique, contrast type, imaging parameters for retrograde urethrogram and voiding cystourethrogram and potential complications. - Normal appearance of anatomy, anatomical variants (diverticulum, Cowper's glands and ducts, ejaculatory duct, glands of Littre', prostatic glands, venous plexus), and associated physiology. - Fluoroscopy techniques in the acute and chronic settings. - Benign pathologies: Infection (acute and chronic, stricture, calculi, fistula), congenital (hypospadias, duplicated urethra), malignancy (primary, metastatic), trauma (anterior injury and posterior injury with Goldman classification Type I-V), post-surgical (urethral stent, urethrostomy, urethroplasty, open urethral reconstruction). - Potential mimics. - Role of fluoroscopic imaging in practice.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The male urethra evaluation using fluoroscopic technique: normal, benign abnormal, malignant abnormal, and mimics.

Conclusion
Evaluation of the male urethra using fluoroscopy requires radiologists to understand the goal of the study based on the provided clinical indication, appropriate imaging technique, as well as the ability to recognized features of benignity and malignancy, and potential disease mimickers.